Work

Does the Lumbar Paraspinal Muscle Status Have a Role in Predicting Mechanical Complications After Adult Spinal Deformity Surgery?

Year: 2025

Type: article

Abstract: Study design Retrospective analysis. Objectives To assess the role of paraspinal muscle morphology in predicting complications after adult spinal deformity (ASD) surgery. Materials and Methods A total of 93 patients who underwent surgery for ASD from 2017 to 2022 were enrolled. Using early postoperative X-ray, they were divided into proportioned (P), moderately proportioned (MP), and severely proportioned (DP) groups based on the Global Alignment and Proportion (GAP) scores. Further, they were classified into two groups: Group A (presence of mechanical complications) and Group B (no mechanical complications). In addition, other parameters including preoperative BMI, smoking status, cross-sectional area (CSA), and grades of paraspinal muscle fatty infiltration (FI) were calculated in all patients using preoperative MRI. These parameters were compared across the groups using a one-way analysis of variance (ANOVA). Post-hoc pairwise testing was done using Bonferroni’s method. These were also compared between groups A and B using a 2-sample t-test. Results The mean follow-up period was 32.7 months (24-64 months). 27 (29%) of 93 patients developed mechanical complications following ASD surgery. Of the 27 patients, 6 (22.2%) were proportioned, 10 (37%) were from MP and 11 (40.7%) were from the DP group. Group A had low CSA ( P = 0.014), and high FI ( P = 0.003) grades compared to group B. Further, 22.2% (6/27) had a history of smoking before surgery (OR = 6.57). Conclusions We recommend consideration of preoperative smoking, CSA, and FI of paraspinal muscles in addition to the GAP score to minimize mechanical complications in patients undergoing ASD surgery.

Source: Global Spine Journal

DOI: 10.1177/21925682251330830